Organization Active NPI

Wasim a Qazi MD PC

  • Internal Medicine Physician
  • Detroit, MI
National Provider Identifier
1376642744
Registry record updated May 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
WASIM A QAZI MD PC
Practice address
6001 W Outer Dr
Suite 420
Detroit, MI 48235-2614
Phone
(313) 341-2545
Fax
(313) 341-2554
NPI assigned
Sep 22, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 5, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Wasim Qazi, MDNPI 1558460998
Title
President / Owner
Phone
(313) 341-2545

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

6001 W Outer Dr
Suite 420
Detroit, MI 48235-2614

Mailing address

6001 W Outer Dr
Suite 420
Detroit, MI 48235-2614
Phone (313) 341-2545

Other identifiers 2

IdentifierTypeStateIssuer
104252490MedicaidMI
0826370OtherMIBLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041011000008 MI Part B Supplier - Clinic/Group Practice 2466411897 Receives reassigned benefits from 1 practitioner
Practice locations: Detroit, MI

National Provider Directory

National Provider Directory

Locations

6001 W Outer Dr
Ste 420
Detroit, MI 48235
Phone (313) 341-2545

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1620172800000",
    "number": "1376642744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6001 W OUTER DR",
            "address_2": "SUITE 420",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482352614",
            "telephone_number": "313-341-2545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6001 W OUTER DR",
            "address_2": "SUITE 420",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482352614",
            "telephone_number": "313-341-2545",
            "fax_number": "313-341-2554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WASIM A QAZI MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-22",
        "last_updated": "2021-05-05",
        "certification_date": "2021-05-05",
        "status": "A",
        "authorized_official_last_name": "QAZI",
        "authorized_official_first_name": "WASIM",
        "authorized_official_title_or_position": "PRESIDENT / OWNER",
        "authorized_official_telephone_number": "313-341-2545",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104252490",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "0826370",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.